My Left Foot

An Undercover and Under Anesthesia Review of a Recent Stay at the BIMC Hospital in Bali

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(1/1/2012)

Bali Update editor J.M. Daniels spent his New Year holiday as a patient at BIMC Hospital in Bali, undergoing surgery for a broken leg. That stay allowed Jack the opportunity to experience first hand the services and accommodation offered by Bali’s leading medical facility.

Now back at work and on the mend, here are Jack’s recollection of his recent stay at BIMC Hospital, information he hopes is useful for visitors to Bali in need of surgical treatment.

Carry on Komang

I’m blaming my mishap on architecture. And, since I took a major hand in the original design of my home in Bali; there’s no one to blame but myself.

I have traversed the stepping-stones over the decorative fishpond marking the entrance to my bedroom thousands of time without incident. But, that all changed on the last Friday of 2011 when, carrying a box of paperwork to my car, I inadvertently dropped my foot between two of the stepping-stones. My foot, twisted at a 45-degree angle as it became firmly lodged betwen the steps as my body continued its forward path. The box of papers flew helter-skelter into the air and my eyeglasses sailed across the garden as my body tumbled forward down a final step. The tumble forward would have been largely unremarkable except for the fact that my ankle remained anchored upright at an obtuse angle to my body and the direction of my fall.

Snap, Snap, Crack, Crack

The resulting sense of impending personal disaster was overwhelming. With a growing appreciation of how the early moments of a medieval quartering must have felt, I found myself laying spread eagle on my steps with my foot still firmly stuck in a between the steps, immoveable at right angles to my body and still pointing skyward.

I instantly knew I done my leg serious damage, a fact confirmed 45-minutes later by x-rays at the BIMC Hospital showing a complete fracture of my left ankle requiring the surgical installation of a plate that could hold the two parts of my ankle together during a 2-3 month healing process.

With insurance that allowed me to choose medical treatment in Bali or Singapore, I chose to have the surgical procedure done at BIMC Hospital in Bali. The straight-forward nature of what is a fairly common orthopedic procedure, the generally excellent reputation of the BIMC hospital, and the chance to complete in two days what could have taken five days (including post-operative recovery time) in Singapore made me opt for treatment “at home” in Bali.

A busy schedule of more urgent surgeries meant that my operation was scheduled for around 10:30 p.m. that night. While waiting for surgery, the doctors and nurses kept me comfortable while undertaking a very thorough range of pre-operative tests and medical interviews to ensure the coming surgery went smoothly.

When I was finally wheeled into the immaculate operating theatre, where even the air is micro-filtered to prevent possible infection, a team of 8 doctors and medical technicians set about their work in a well-coordinated and highly professional manner.

Remembering to Breathe

Based on my medical history and pre-operative consultations, the medical team opted for a spinal anesthesia, an approach that leaves the lower half of the body wholly insensitive to any sensation and is generally considered to be less burdensome on the respiratory and coronary systems. Now, in retrospect, their decision proved keenly prescient when, during the actual operation, I had an adverse reaction to the relatively mild sedative used to put the the remaining "upper half" of me “to sleep” interrupted my breathing. The vigilant medical team quickly detected my failure to breathe and immediately stopped the sedation. As I regained consciousness, I heard the voice of the anesthetist imploring, “Mr. Jack, don’t forget to breathe” and engaging me in active conversation for the rest of the operation to make sure I stayed awake as he provided me with a continuous supply of oxygen.

Modern anesthesia allows the use of “regional anesthesia” blocking all sensation to selected areas of the body, leaving the remaining parts largely unaffected. Because my mental sedation had come to a premature but necessary end, I had the surreal “out of body” experience in which I was fully conscuous as I heard doctors drilling six pins into my ankle - all done without any pain or any sensation at all.

While this may be more medical detail than many would like, the story bears retelling for the excellent teamwork and professionalism demonstrated by surgical team and how their quick thinking prevented a minor problem from turning into something more significant.

If the doctors had opted for a general anesthesia the respiratory problems could have potentially necessitated an abrupt end to the operation.

After the surgery and as an added precaution, the doctors kept me under close observation in the ICU for the remainder of the night, ensuring here were no further ill effects from the sedative.

The next dayI was moved to a private room where I stayed overnight until the following morning when I was discharged on crutches, now fated to be my steadfast companion for the next 2-3 months.

While there are perhaps better places to spend New Year’s Eve than a hospital room, I will long remember the professional and unfailingly gentle care and attention provided me by the doctor’s and nurses at the BIMC Hospital.

And while no wants to be sick or injured while living or holidaying in Bali, it’s very comforting to know that the island enjoys the high level of professional medical care provided by the good folks at BIMC Hospital.

Shown on Balidiscovery.com is Jack's post operative left foot now home to six stainless steel screws.